Reproductive Health Matters An international journal on sexual and reproductive health and rights ISSN: 0968-8080 (Print) 1460-9576 (Online) Journal homepage: https://www.tandfonline.com/loi/zrhm20 Sexual violence against men and boys in conflict and forced displacement: implications for the health sector Sarah K Chynoweth, Julie Freccero & Heleen Touquet To cite this article: Sarah K Chynoweth, Julie Freccero & Heleen Touquet (2017) Sexual violence against men and boys in conflict and forced displacement: implications for the health sector, Reproductive Health Matters, 25:51, 90-94, DOI: 10.1080/09688080.2017.1401895 To link to this article: https://doi.org/10.1080/09688080.2017.1401895 © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group Published online: 11 Dec 2017. Submit your article to this journal Article views: 2446 View Crossmark data Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=zrhm21 SPOTLIGHT Sexual violence against men and boys in conflict and forced displacement: implications for the health sector Sarah K Chynoweth,a Julie Freccero,b Heleen Touquetc a Research Fellow, WSD Handa Center for Human Rights and International Justice, Stanford University, Stanford, CA, USA. Correspondence: [email protected] b Director, Health & Human Rights Program, Human Rights Center, School of Law, University of California, Berkeley, CA, USA c Assistant Professor, Leuven International and European Studies, University of Leuven (KUL), Leuven, Belgium Abstract: Sexual violence against men and boys is commonplace in many conflict-affected settings and may be frequent in relation to forced displacement as well. Adolescent boys, forming the majority of unaccompanied minors globally, are a particularly vulnerable group. Yet sensitised health services for adult and adolescent male sexual violence survivors are scarce, and barriers to accessing care remain high. We describe current challenges and gaps in the provision of health care for male survivors in settings affected by conflict and forced displacement, and provide suggestions on how to improve service provision and uptake. DOI: 10.1080/09688080.2017.1401895 Keywords: sexual violence, humanitarian, men and boys, male, health Introduction refugees described being sexually preyed upon by In the fall of 2016, two of the authors travelled to multiple perpetrators. Yet, many aid workers, refugee settings in the Middle East and Greece, including health providers, were either unaware respectively, to undertake projects related to sex- of these problems or were unsure how to address ual and gender-based violence.* We heard disturb- them. Some did not believe men or boys were ing accounts of sexual violence, including sexual being sexually victimised. One gender-based vio- exploitation and abuse, against refugee men and lence programme manager in Iraq described boys and found few accessible services available, how, when she raised the issue during a training particularly for adolescent boys and adult men.† on post-rape care, doctors and nurses burst out In the Middle East, refugees shared horrific stor- laughing, “How can a man be raped?” ies of sexual violence, including sexual torture and In Greece, shelter providers told stories of older rape, against men and adolescent boys in Syria by men sexually exploiting unaccompanied boys aged both state and non-state actors. In their countries 14–17 in Pedion tou Areos, a large park in Athens, of asylum, some refugees reported sexual exploita- in exchange for money, food, clean clothing, and tion of men and boys. Gay and transgender other basic needs. Despite widespread acknowl- edgement of this problem, practitioners lacked the guidance and evidence-based approaches *SKC travelled to Lebanon, Jordan, and the Kurdistan region of necessary to prevent these boys from being repeat- Iraq in October 2016 to undertake research for UNHCR on sex- edly exposed to sexual abuse. When boys disclosed ual violence against men and boys in the Syria crisis. JF was this form of harm, providers often did not know deployed as a Gender-based Violence Specialist to UNFPA in where to refer them for appropriate medical and Greece from August 2016 to January 2017 to develop and coor- psychosocial care. dinate responses to gender-based violence against refugees, In this paper, we spotlight the needs and gaps in migrants, and asylum seekers in camps and urban settings. physical health service provision for male survivors †Note that sexual and gender-based violence services for in conflict-affected settings as well as situations of women and girls require significant strengthening across forced displacement. Sexual violence against men these settings as well. and boys includes oral and anal rape including 90 © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons. org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. SK Chynoweth et al. Reproductive Health Matters 2017;25(51):90–94 with objects, genital violence, forced sterilisation the men reported experiencing sexual abuse such as castration, sexual slavery, forced sexual while in transit through Mexico.9 activity with other people, animals, or corpses, For unaccompanied boys, the issue has reached and other forms of sexualised violence of compar- new urgency as the number of registered unac- able gravity.1 companied children – the majority of whom are male – has risen five-fold globally since 2010.10 The refugee and migrant crisis in Europe in par- The burden on men and boys ticular has drawn global attention to the sexual Although limited research on sexual violence exploitation and abuse of unaccompanied adoles- against males in conflict has been undertaken, in cent boys, who comprised 89% of the 63,300 unac- settings where it has been explored, conflict- companied minors applying for asylum in the related sexual violence against men and boys has European Union in 2016.11 Although empirical been identified as “regular and unexceptional, per- research is limited, aid worker accounts, media vasive, and widespread”.1 For example, in selected stories, and UN, NGO, and academic reports high- conflict-affected territories of the eastern Demo- light that unaccompanied boys experience sexual cratic Republic of the Congo (DRC), a population- exploitation and abuse both during migration based survey found that almost one quarter of and upon arrival in destination countries. For men (23.6%) had experienced sexual violence.2 A example, a 2016 study involving 61 interviews survey of men living in a conflict-affected state in with unaccompanied migrant children in camps Sudan revealed that almost half (46.9%) had in Northern France and along the coast of the Eng- experienced or directly witnessed the sexual lish Channel found that boys and girls were regu- abuse of a man.3 In Liberia, a population-based larly sexually abused by traffickers.12 It noted survey unveiled that one-third (32.6%) of former that along the migration route from Afghanistan male combatants reported experiencing sexual vio- to Calais, in particular, “sexual abuse of boys lence.4 Sexual violence against men and boys was appears to be commonplace”.12 In Libya, a needs widespread during the conflict in the former Yugo- assessment of 122 migrant women and children slavia, as documented by Amnesty International who were travelling along the Central Mediterra- and in UN reports, as well as by the International nean migration route from North Africa to Italy Criminal Tribunal for the former Yugoslavia and found sexual violence to be widespread at borders domestic courts.5,6 and checkpoints, and noted that boys experience Sexual violence against boys and men in “various forms” of sexual violence during relation to forced displacement has also been migration.13 The sexual abuse and exploitation of documented. Of the incidents of rape reported to unaccompanied adolescent boys upon arrival in the Gender-based Violence Information Manage- Europe has been increasingly documented in ment System (GBV IMS)‡ in Lebanon from January Greece and Italy.14,15 A 2017 study on this issue to May 2016, for example, 20% were reported by in Greece described the sexual exploitation of refugee men and boys; the total number of survi- boys from Afghanistan, Syria, Iraq, Iran, and Ban- vors was not specified.7 Keygnaert et al8 found gladesh. Desperate for money to survive in Greece that men were the victims in 53 (37.2%) of 142 or to pay a smuggler to leave, they were sexually reported incidents of rape among sub-Saharan abused in parks, hotels, or private residences for refugees and asylum seekers in Morocco. A Méde- small payments.16 While most of the documen- cins Sans Frontières survey of 429 refugees fleeing tation of sexual exploitation and abuse of boys is violence in Central America found that 17.2% of focused on the route to Europe, other dangerous routes expose children to sexual and physical vio- ‡GBV IMS is a data management system that enables service lence, such as the route from Central America to providers working with survivors of sexual and gender-based the United States, and the route from Myanmar violence to safely collect, store, analyse, and share data. through Southeast Asia.10 Note that GBV IMS data are from reported cases only and are not representative of the total incidence or prevalence of sexual and gender-based violence in each setting. In the Middle Health impact and gaps East, for example, a number of agencies providing services to Sexual violence has destabilising, multi-dimen- male survivors have not adopted the use of the GBV IMS and sional consequences, and the physical health their data are, therefore, not included in the GBV IMS data. impact alone on male survivors can be significant.